Accepted for/Published in: JMIR Research Protocols
Date Submitted: Apr 24, 2023
Date Accepted: May 25, 2023
Evaluating an Innovative HIV Self-testing Service with Online Real-time Counseling Provided by an Artificial Intelligence Chatbot (HIVST-Chatbot) in Increasing HIV Self-testing Utilization among Chinese Men Who Have Sex with Men: Protocol for a Randomized Non-inferiority Trial
ABSTRACT
Background:
Counseling supporting HIV self-testing (HIVST) users is essential to ensure support and linkage to care among men who have sex with men (MSM). An HIVST service with online real-time instruction, pre-test and post-test counseling provided by trained administrators (HIVST-OIC) was developed by previous projects. Although the HIVST-OIC was highly effective in increasing HIVST uptake and the proportion of HIVST users receiving counseling along with testing, it required intensive resources to implement and sustain. The service capacity of HIVST-OIC cannot meet the increasing demands of HIVST.
Objective:
The primary objective of this randomized controlled trial (RCT) is to establish whether HIVST-Chatbot, an innovative HIVST service with online real-time instruction and counseling provided by a fully automated Chatbot, would produce effects that are similar to HIVST-OIC in increasing HIVST uptake and proportion of HIVST users receiving counseling alongside testing among MSM within a six-month follow-up period.
Methods:
A parallel-group non-inferiority RCT will be conducted. Participants are Chinese-speaking MSM aged 18 years or above with access to live-chat applications. A total of 528 participants will be recruited through multiple sources, including outreach in gay venues, online advertisement, and peer referral. After completing the baseline telephone survey, participants will be randomized evenly into the intervention or control groups. Participants in the intervention group will watch an online video promoting HIVST-Chatbot and receive a free HIVST kit. The Chatbot will contact the participant to implement HIVST and provide standard-of-care and real-time pre-test and post-test counseling, and instruction on how to use the HIVST kit through WhatsApp. Participants in the control group will watch an online video promoting HIVST-OIC and receive a free HIVST kit in the same manner. Upon appointment, a trained testing administrator will implement HIVST and provide standard-of-care and real-time pre-test and post-test counseling and instruction on how to use the HIVST kit through live-chat applications. All participants will complete a telephone follow-up survey six months after the baseline. The primary outcomes are HIVST uptake and the proportion of HIVST users receiving counseling support along with testing in the past six months measured at Month 6. Secondary outcomes include sexual risk behaviors and uptake of HIV testing other than HIVST during the follow-up period. Intention-to-treat analysis will be used.
Results:
Recruitment and enrollment of participants will start in April 2023.
Conclusions:
This study will generate important research and policy implications regarding using Chatbot in HIVST services. If HIVST-Chatbot is proven non-inferior to HIVST-OIC, it can be easily integrated into existing HIVST services in Hong Kong. The coverage of HIV testing and the level of support to HIVST users will be increased. Clinical Trial: The study was registered at ClinicalTrial.gov (number NCT05796622).
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